Assuntos
Doença de Crohn/microbiologia , Histoplasma/isolamento & purificação , Histoplasmose/diagnóstico , Terapia de Imunossupressão/efeitos adversos , Imunossupressores/efeitos adversos , Idoso , Doença de Crohn/tratamento farmacológico , Histoplasma/ultraestrutura , Humanos , Masculino , Língua/patologiaRESUMO
A husband and wife became unwell after eating a fish from the Calder River in northern Western Australia. Gnathostomiasis was diagnosed, and treated with ivermectin and albendazole. Serological testing was positive for gnathostomiasis, and there has been no recurrence. These appear to be the first proven endemically acquired cases of gnathostomiasis in Australia, and demonstrate the difficulties in diagnosis and treatment.
Assuntos
Albendazol/uso terapêutico , Antinematódeos/uso terapêutico , Gnathostoma , Gnatostomíase/diagnóstico , Gnatostomíase/tratamento farmacológico , Ivermectina/uso terapêutico , Animais , Quimioterapia Combinada , Feminino , Gnathostoma/imunologia , Gnathostoma/isolamento & purificação , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Austrália OcidentalAssuntos
Proteínas de Bactérias/biossíntese , Farmacorresistência Bacteriana , Klebsiella pneumoniae/enzimologia , beta-Lactamases/biossíntese , Compostos Azabicíclicos/uso terapêutico , Carbapenêmicos/farmacologia , Ceftazidima , Humanos , Infecções por Klebsiella/tratamento farmacológico , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Metronidazol/uso terapêutico , Pessoa de Meia-Idade , Pancreatopatias/microbiologia , Teicoplanina/uso terapêuticoAssuntos
Filariose Linfática/diagnóstico , Adulto , Austrália , Dietilcarbamazina/uso terapêutico , Doxiciclina/administração & dosagem , Doxiciclina/uso terapêutico , Quimioterapia Combinada , Filariose Linfática/tratamento farmacológico , Filariose Linfática/patologia , Filaricidas/administração & dosagem , Filaricidas/uso terapêutico , Humanos , Masculino , Cordão Espermático/parasitologia , Cordão Espermático/patologiaRESUMO
AIMS: Diagnostic microbiology for community acquired pneumonia (CAP) provides useful information for patient management, infection control and epidemiological surveillance. Newer techniques enhance that information and the time interval for obtaining results. An audit of diagnostic microbiology utilisation, microbiological aetiology, and influence of results on prescribing practices in CAP in a regional Australian hospital setting was performed. METHODS: Clinical, microbiological and outcome data were collected by medical record review of patients discharged from Ballarat Hospital with a diagnosis of CAP over a 12 month period. RESULTS: Of 184 identified CAP episodes, 47 (25.5%) had no diagnostic microbiology performed. Respiratory virus polymerase chain reaction (PCR) was rarely performed (2.7% of all episodes). Acute serology was frequently requested, however paired acute and convalescent serology was infrequently performed (5/75 testing episodes; 6.7%). CAP severity was not correlated with microbiological investigation intensity. The most common pathogens identified were Streptococcus pneumoniae and Mycoplasma pneumoniae (5.4% and 2.2%, respectively). Diagnostic testing appeared to rarely influence antimicrobial prescribing. CONCLUSIONS: In this setting, diagnostic microbiological tests such as respiratory virus PCR and urinary antigen tests are under-utilised. In contrast, sputum and serological investigations are commonly requested, however rarely influence practice. Interventions to facilitate efficient usage of diagnostic microbiology are required.